This will be a controlled clinical trial at field site, Howard University Medical Center in Washington, DC, involving 138 older African American men and women (55 years of age and older) with documented atherosclerotic CVD who will be randomized to supplementation with either the traditional CAM herbal preparation (MAK 4+5), conventional vitamin cocktail (E+C) or placebo for 12 months. Clinical and mechanistic outcomes include carotid artery atherosclerosis (IMT), endothelial dysfunction (brachial artery reactivity), oxidized LDL, traditional CVD risk factors (BP, lipids, diet, exercise, smoking, weight) and quality of life. Participants will continue usual care. The results of this clinical study will provide much needed understanding of the basic and clinical effects of a traditional herbal antioxidant preparation on pathophysiological mechanisms of atherosclerotic CVD in this high risk group. This will facilitate translation of research findings on CAM into clinical practice for prevention of disease in this underserved and understudied population of high risk older African Americans.